Here’s the abstract (full article here) for an interesting article I came across, “Kafka, paranoic doubles and the brain: hypnagogic vs. hyper-reflexive models of disrupted self in neuropsychiatric disorders and anomalous conscious states, ” by Aaron L Mishara:
Kafka’s writings are frequently interpreted as representing the historical period of modernism in which he was writing. Little attention has been paid, however, to the possibility that his writings may reflect neural mechanisms in the processing of self during hypnagogic (i.e., between waking and sleep) states. Kafka suffered from dream-like, hypnagogic hallucinations during a sleep-deprived state while writing. This paper discusses reasons (phenomenological and neurobiological) why the self projects an imaginary double (autoscopy) in its spontaneous hallucinations and how Kafka’s writings help to elucidate the underlying cognitive and neural mechanisms. I further discuss how the proposed mechanisms may be relevant to understanding paranoid delusions in schizophrenia. Literature documents and records cognitive and neural processes of self with an intimacy that may be otherwise unavailable to neuroscience. To elucidate this approach, I contrast it with the apparently popularizing view that the symptoms of schizophrenia result from what has been called an operative (i.e., pre-reflective) hyper-reflexivity. The latter approach claims that pre-reflective self-awareness (diminished in schizophrenia) pervades all conscious experience (however, in a manner that remains unverifiable for both phenomenological and experimental methods). This contribution argues the opposite: the “self” informs our hypnagogic imagery precisely to the extent that we are not self-aware.
Perverse Egalitarianism 
Thanks for finding and sharing this article. Despite a few odd mistakes (Titorelli is the painter in The Trial not Tintoretto! And It’s Dora Diamant not Dorothy), he seems to know Kafka’s work well and appreciates it unlike the dreadful Jonathan Gottschall.
Yeah, I found the article fascinating. I’m glad that you confirmed the confusion of Titorelli/Tintoretto in the article. In fact, for some reason when I noticed that I instantly thought of that scene in Orson Welles version of The Trial in which Anthony Perkins, as K, meets Titorelli (here’s the link)
I didn’t catch the other mistake, however!
Agreed, this is very interesting. My anecdatal observation is that delusional disorder involves an intensification of the kind of reflexivity associated with normative judgment, possibly associated with sleep disorder or a more comprehensive confusion of perceptual and imaginative states. This is quite different than reflective self-awareness.